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Normal findings on pretreatment transcranial ultrasound in patients treated with sonthrombolysis
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
2014 (English)In: Interventional Neurology, ISSN 1664-9737, Vol. 3, no 1, 1-8 p.Article in journal (Refereed) Published
Abstract [en]

In populations with a high (≥14) median National Institute of Health Stroke Score (NIHSS), a normal finding of Thrombolysis in Brain Ischemia grade 5 (TIBI 5) in the artery of interest has been reported to be an unusual finding when transcranial ultrasound is performed during thrombolysis. In such instances, a stroke mimic can be suspected, but there are alternative pathophysiological explanations. In this case series, the median NIHSS was relatively low (5), and 33% (6/18) of the patients treated with thrombolysis had TIBI 5 in the artery of interest at the time of treatment initiation. These 6 patients had normal findings on the computerized tomography angiography. Only 33% (2/6) of these patients were stroke mimics, the remaining had either lacunar (n = 2) or cortical strokes (n = 2). These cortical stroke patients probably had a pretreatment recanalization marked by partial symptom regression before treatment onset. Compared to patients with TIBI <5 at baseline, the patients with TIBI 5 at baseline tended to be younger (p = 0.19, Mann-Whitney test) and more often have lacunar syndrome (p = 0.18, chi(2) test). Thus, among patients treated with thrombolysis and with a low median NIHSS, a finding of TIBI 5 is not unusual. This does not mean that the patient has a stroke mimic per se, and it tends to be more common among patients with lacunar syndrome than among patients with cortical syndromes.

Place, publisher, year, edition, pages
2014. Vol. 3, no 1, 1-8 p.
Keyword [en]
Sonothrombolysis, Stroke, Thrombolysis, Thrombolysis in Brain Ischemia grade, Transcranial ultrasound
National Category
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-106089DOI: 10.1159/000365555PubMedID: 25999985OAI: oai:DiVA.org:umu-106089DiVA: diva2:840165
Available from: 2015-07-07 Created: 2015-07-07 Last updated: 2015-09-24Bibliographically approved

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Johansson, EliasWester, Per

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